Active NPI
Rita Youkhana, PA-C
- Physician Assistant
- Madison Heights, MI
National Provider Identifier
1184097701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601007700
- Practice address
- 30581 Stephenson Hwy
Madison Heights, MI 48071-1610 - Phone
- (248) 589-1770
- Fax
- (248) 589-2838
- NPI assigned
- Nov 4, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601007700 | MI | Primary |
Addresses
Primary practice location
30581 Stephenson Hwy
Madison Heights, MI 48071-1610
Mailing address
13636 Dix Toledo Rd
Southgate, MI 48195-2432
Phone (734) 283-8121
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160913000068 | MI | Practitioner - Physician Assistant | 4284920513 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601007700 | MI | MD | Physician Assistant |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1446595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472774400000",
"number": "1184097701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13636 DIX TOLEDO RD",
"city": "SOUTHGATE",
"state": "MI",
"postal_code": "481952432",
"telephone_number": "734-283-8121",
"fax_number": "734-589-2838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30581 STEPHENSON HWY",
"city": "MADISON HEIGHTS",
"state": "MI",
"postal_code": "480711610",
"telephone_number": "248-589-1770",
"fax_number": "248-589-2838"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUKHANA",
"first_name": "RITA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-04",
"last_updated": "2016-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601007700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Madison Heights, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.